One of the results of modern medicine is that many of us think a "normal" illness is one that can be cured. We are profoundly unsettled by illnesses which cannot be fixed, and we do not associate willingly with people who have such illnesses, preferring that they keep decently to themselves in hospitals and nursing homes. We certainly don't marry people with intractable illnesses. We may say "in sickness and in health, until death do us part" when we marry, but we make sure to marry someone who is healthy now and whom we imagine will be so forever. These were my own assumptions when the man I was dating in graduate school told me he was HIV positive. "How can I marry this man?" I thought. "He's going to die." "You can't marry this man; he's going to die," my friends told me. Illness and death are abnormal experiences. We avoid them at all costs, even if that means excluding ill or dying people from our lives. But marry him I did, and from the beginning our marriage was overshadowed by this illness and the likelihood of his early death. This set us apart from our friends, who seemed to enjoy perfect health, and it challenged our own ideas and expectations of our lives. We also found that the Christian faith unmasked and illuminated some of our assumptions about life and death in ways that were surprising and transforming. We learned this mostly through worship and prayer and pastoral care; but I've since discovered that we were not the first Christians ever to learn these lessons.nAmong the Christian teachers who discuss the subjects of health and illness directly are Basil the Great (c. 330-79), Martin Luther (1483-1546), and Jeremy Taylor (1613-67). Each of these thinkers reflects on how God's grace and providential care shape what it means to be sick and to be a child of God. Basil, Luther, and Taylor, in contrast to many of us, lived in times and places when death came swiftly and unexpectedly to many. As a result, they did not share our temptation to suppose that a "normal" illness is a curable one, and that death is abnormal and dying people are to be avoided. Rather, they remind us that death is the destiny of every human being, and that we do well to keep that reality always before us. You are going to die, and probably sooner than you think, so be ready. Don't let an event as important as death take you by surprise. Instead, live in a way that prepares you for the inevitable. Taylor suggests that a Christian should treat every illness as though it will end in death. Too often, because they are afraid to die, people cope with illness, however severe, by imagining that of course they will get better. The result is that these people die unprepared—with their affairs in a mess and their relatives unprovided for, with their souls not properly cared for, and their burdens of conscience not dealt with. They think they are being brave, but they are really being cowards. They are so afraid to die that they refuse to take steps to assure that they die well rather than badly. This is not behavior which is fitting in a Christian, says Taylor. Make a will, confess your sins, receive the Lord's Supper. Doing these things will not make you die sooner, and they will certainly help you die better. Similarly, Martin Luther, in a pastoral letter written in the midst of a plague, urges people not to wait until they are on their deathbeds to live like Christians. Go to church, he says, and listen to God's Word, so that you know how to live and how to die. Be reconciled with your neighbor, and make a will, so that if the Lord comes for you suddenly, you will have provided for your soul, ordered your affairs, and committed yourself to God. It is certainly a natural and a good thing to wish to preserve your life, and a Christian should feel free to consult with doctors and receive whatever medical advice and care the doctor may offer. But the doctor operates within the providence of God. All the physicians in the world could not heal us if God were absent, and no harm can possibly overtake us when God abides with us. God will take us to himself in his good time, and not before, so we need not be preoccupied with avoiding death at all costs. As my husband's health began to fail, we began to make preparations for his death. We made wills, we met with a funeral director, and we bought a cemetery plot. We decided that we wanted the stone marker on his grave already there when he was buried, and so we selected a stone and had it engraved and set in place. We had relatives who were buried in the same cemetery, and we had often visited their graves and taken photographs of ourselves and other family members at their gravestones. So when we visited the cemetery to see my husband's newly-laid gravestone, we took a picture of him next to his gravestone. He is sitting cross-legged on the ground, looking straight into the camera, and in front of him is a flat stone with the legend "I know that my redeemer liveth," and under it his name and the year of his birth, with a space next to it for the year of his death. It is a photograph at once macabre, and darkly funny, and soberly realistic. He is dying, and he knows it, and he also knows that his redeemer lives, and that he is soon to see him face to face. Isn't this how a Christian ought to live, and ought to die? Many of us tend to think that every person has an absolute right to freedom from pain, disease, and disability. Suffering should not characterize our lives. A normal life is lived in good health; in a normal family everybody is healthy. So when someone falls ill, we expect all the resources of modern medicine to rally around and make it better. We expect the best care money can buy, and we expect it to be covered by insurance. If we are Christians, we are tempted to baptize these attitudes, and to think that a normal Christian life is one lived in perfect health. Isn't sickness contrary to God's presence and power in the life of a Christian? Basil, Luther, and Taylor, by contrast, affirm that every human being can expect to suffer, and that caring for the sick is a common human duty. Basil explains that in paradise there was no illness, but as a result of sin, humans became subject to the decay and dissolution of their bodies through death and disease. God therefore gave humans the art of medicine, in order to relieve the sick, at least to some degree.This does not mean that medicine itself is wholly responsible for a person's health or illness. Doctors are not our saviors. Healing comes from God, however it may come, only if and when God chooses to grant it.God may sometimes heal directly through prayer, if he thinks this will be good for our souls. Sometimes he wills that we receive healing through recourse to the art of medicine. If God grants us healing in this way, we should receive it with thanksgiving, giving glory to God and thanksgiving for God's creation of the art of medicine. But God does not always heal people who are ill, and therefore when we are ill we need to pray not only for healing, but also for understanding and endurance, so God will cause us to bear the suffering which has come to us.These Christian teachers do not see suffering as utterly opposed to God's purposes for human life. Sickness can come to us from the hand of God as an instrument in our salvation. This is not to say that God is bound to afflict every Christian with illness. Taylor says God is perfectly capable of making people holy without making them sick. But God's intention for human wholeness may include illness, and illness can always be turned by God to our ultimate good and his ultimate glory. Sickness offers an opportunity for growing in the Christian virtues of faith, hope, and love. In deed, sickness, like persecution or temptation, can be an occasion when a person's faith is shown for what it really is. "We readily trust [God] for life when we are in health," says Taylor. "But let us come to sit upon the margin of our grave hellip; then can you believe?"My husband spent the last two weeks of his life in a hospital intensive-care unit, getting treatment for AIDS-related pneumonia. He was on a ventilator and heavily medicated, drifting in and out of lucidity as his morphine levels varied. Eventually it became clear that he was not going to survive. It was my job to explain this to him, and I did the best I could through his morphine-induced haze. I told him he had an infection and his kidneys were starting to fail. I said I knew he wanted to live but that it looked like this was his time to die, and my time to go on without him, for a little while at least.Because he was on the ventilator, he couldn't speak, but he looked at me with the most unutterable sadness in his eyes; and then, on a pad of paper, he wrote four words: "focusing on God's sovereignty." He died the next day—an obedient death. He wanted to live, but he knew that it was his time, and he bowed to God's sovereign will. Can there be a greater act of faith? It is very easy for many of us, living in a culture which glorifies independence, to imagine that self-sufficiency is a normal human state. Dependent people are somehow defective and not fully adult. Illness is a problem, because it is not possible both to be seriously ill and to be independent. A sick person requires care from doctors, pastors, family members, and friends. A sick person may not be able to work for wages or to help with household duties. And a sick person both feels and is extremely vulnerable to infection, fatigue, discouragement, and pain.Before we got married, my husband and I wondered whether it would be possible for us to have a mature, stable, and intimate marriage, given our expectations of his illness and likely early death. Isn't a person who is "marriage material" someone whom you have reason to think will never really need anything from you?For that matter, isn't a good friend or colleague or family member someone whom you believe will never be in need, and to whom you would never wish to "be a burden"? Absolutely not, says Martin Luther. For Luther, the good news of the gospel is that people who have been saved by grace are liberated from self-concern and thus enabled to pour out their lives in love for one another. This means we help our neighbor who is in need, and are ready to receive from our neighbor when we are in need. When the plague arrived in Luther's city and many people fled out of fear for their lives, Luther stayed behind to minister to the sick and dying. In his pastoral letter, Luther said that a pastor may leave a plague-stricken city only if enough other pastors are staying behind to provide spiritual care for those who are ill.Similarly, public officials, like constables and physicians, are obliged to remain in order to provide essential community services. Guardians or friends must take responsibility for orphaned children; neighbor must not leave neighbor unless there are others who will care for the sick and nurse them. To all these the word of Christ stands as a warning: "I was sick and you did not visit me" (Matthew 25:41-46). "According to this passage," says Luther, "we are bound to each other in such a way that no one may forsake the other in his distress but is obliged to assist and help him as he himself would like to be helped."The care we owe our neighbors in time of plague is like the care we owe them in other troubles: fire, personal calamity, hunger, thirst. We must disregard risk to ourselves and help our neighbors in whatever way they require. Luther is aware of the terror of an epidemic, and of the horror and repugnance which one may experience in the presence of a gravely ill person. We can be confident, he says, that one of the reasons God may send illness upon us or among us is to test our faith in God and our love for the neighbor. To serve the neighbor in love delights God, and allows us to demonstrate our gratitude for and joy in the shed blood of Christ.God encourages those who care for the needy with mighty promises: "Blessed is he who considers the poor. hellip; The Lord protects him and keeps him alive. hellip; The Lord sustains him on his sickbed; in his illness he will heal all his infirmities" (Psalm 41:1-3, RSV). How can anything deter us from the care of the sick, when God offers promises like this to us? Are we to be more afraid of a person with an infectious disease—like plague, or AIDS—than we are emboldened by the sure and certain promises of God? During my husband's illness, we were members of a small-group Bible study at our church. We had been placed deliberately in this group by one of our pastors who hoped these people would be up for the challenge of enfolding a needy couple like ourselves. And they were: not because they were people of heroic virtue, but because they were willing to love and care for us in our neediness. In that group, my husband got to care for others, as well as to be cared for by them; to share their lives, to play with their children, to be part of the family of the church.When my husband died, the six other men in the group were his pallbearers. I emerged from the church after the funeral into crisp air and blue sky and brilliant sunshine, and watched these six men, more dressed up than I'd ever seen them, with white carnations in their lapels, carrying the casket down the steps of the church and putting it in the hearse. These were the people who had been carrying us along through all of my husband's illness; and when they could do nothing more for us than carry his body, they carried his body. We trusted our very lives to them, and they did not let us down.It is tempting to imagine that there is a simple, clear-cut relationship—or lack of relationship—between sin and illness. For some, illness is the result of some particular sin; a person who is living a holy life will enjoy good physical health. Others find it troubling that a sick person should be blamed for the illness and are inclined to deny any relationship at all between physical health and spiritual health. Confusion on this subject intensifies in the case of an illness like AIDS. Because AIDS is often associated with drug abuse and unchastity, some Christians conclude that anyone who has such an illness must deserve to have it. Others, not wanting to blame the sufferer, think the only solution is that sin and illness have no connection with one another.Our authors suggest that things are not that simple. They are inclined to think there is a relationship between physical health, illness, holiness, and sin, but that these relationships are complex and often paradoxical. Jeremy Taylor begins with some obvious advice. Don't make your self sick through drunkenness, gluttony, lust, or other vices. Instead, be careful that sin does not cause you to become sick. If you do get sick, repent, supposing that even if sin has not caused your sickness directly, it may have had some indirect influence nonetheless.Taylor warns, however, that while it is easy to discover "loud and clamorous" sins, sin is a subtle and a complex thing. The soul's diseases are more numerous and complex than the body's ills; so we should not try to identify precisely what sin might be causing a particular illness, but should rather at tempt to repent fully and to return heartily to God, that we may be restored to health and life.Basil offers the opinion that there are some instances in which illness may have a spiritual rather than a physical cause. God may impose illness on us as a punishment for sin and as an invitation to repentance. But illness may also afflict us at the instigation of the Evil One. In these cases, God condescends to enter into combat with the Evil One, and confounds his boasts by the heroic patience of his servants. This is what happened to Job. It could happen to you or to me. God also calls some persons to suffer illness as models for the weak. This is what happened to Lazarus: he was afflicted by painful wounds, but he bore his suffering without recrimination or peevishness, and God caused him finally to rest in the bosom of Abraham as an example to us all (Luke 16:19-31).The illness of great saints can serve to make plain their human frailty. Some people were tempted to think the apostle Paul was superhuman, and so Paul calls attention to his prolonged struggles with an infirmity as a means of demonstrating his humanity (2 Corinthians 12:7). Thus, the mere fact that a person is ill tells us nothing about the reasons for that illness. That is a matter for discernment, and sometimes (as in the case of Job) those reasons are never revealed to the person or to any of his associates.Where we are aware of sin in our lives, says Basil, we should repent, and should regard any physical healing we receive as a sign of hope that our souls may likewise be healed. Taylor urges his readers not to despair, even if they think their illness may be the result of sin. We should remember that in the midst of judgment God remembers mercy, and causes even this affliction to work for our good. And, he points out, it may be that sin has nothing to do with our illness, because it is not only the guilty who get sick. God sends illness also "to his servants, to little infants, to Apostles and Saints, with designs of mercy, to preserve their innocence, to overcome temptation, to try their virtue, to fit them for rewards."My husband and I were very well aware of the tendency of many Christians to see AIDS as an illness whose victims are "guilty" and therefore deserving of stigmatization and punishment. Those whose lives are touched by AIDS are often tempted not to tell anyone, for fear that they will be condemned and shunned if their secret were known. This is what my husband and I did for the first year or two of our marriage. Eventually, we began telling people, and we were relieved to find that their responses were uniformly loving and supportive. We ended by being a little ashamed that we had not expected better of them to begin with. However, we did not tell people how my husband became infected. We did not want to offer anyone the option of pigeonholing him as "innocent" or "guilty," supposing that this made some sort of difference in the present. Rather, we wanted to walk together with our fellow Christians toward our common goal of wholeness and healing in Christ.Many of us think that health is equivalent to the absence of sickness—you are healthy as long as you aren't sick. But if we think of health in terms of wholeness, we can see there is much more to it than that. Health, for a Christian, is fitness for life in communion with God and with God's people. People are healed as they are brought into closer relationship with God and neighbor, and enabled to embody God's purposes in the world. This can happen even when a person suffers from physical illness.Taylor notes that sickness can bring a person to repentance, virtue and pardon, although it does not do so automatically. We have all known persons whose illness left them bitter and selfish, rather than holy and loving. Sickness can lead to the cure of the soul, but that does not mean God requires nothing more. Being sick is no different from being healthy: God calls all persons to lives of Christian discipleship, regardless of their state of health.Basil discusses ways in which spiritual wholeness can be experienced even when physical healing is slow or does not come at all. He thinks that part of the reason God often does not heal people simply through prayer, but chooses to work through the ministrations of physicians and medicines, is to show us by analogy what the proper care of the soul is like. The medical treatment of physical illness can involve considerable short-term unpleasantness in the hope of long-term improvement. We should not be surprised when the care of the soul is similarly unpleasant. The practice of medicine can involve cutting, burning, and administering bitter medicines. We should be prepared, says Basil, to have the cure of the soul involve "the cut of the reproachful word and the bitter medicine of penalties."Similarly, many physical illnesses require a great deal of treatment over a long period of time. This is an indication that the care of the soul may involve much effort in the form of prayer, repentance, and spiritual discipline before any real healing occurs. The most important thing, for Basil, is that Christians respond to illness in a manner which expresses trust in God and promotes spiritual growth. If over the course of your illness you are brought more closely into conformity with Christ, then God is making you fit for the kingdom of heaven, whether or not you experience physical healing.This all sounds rather upbeat and positive, a look-on-the-bright-side theology of illness: at least when you suffer, you're becoming more like Jesus. In fact, as all who have suffered illness and the death of loved ones know, feelings of desolation and anger, even bitterness, are very much a part of any deep experience of loss.My own feelings of bitterness came more during my husband's life than after his death. It felt as though God had brought my husband into my life, only to take him away again. It felt tremendously unfair and unkind, like God was doing this to me deliberately, to torment me; or (just as bad) to make me a better person by torturing my husband to death while I watched. It took a long time for this to subside. In fact, it really didn't go away but was transformed into a recognition of all the enormous good that my husband and I experienced, and the hidden wisdom of God that was embodied in our life together—and in his death.In a strange and paradoxical way, my husband was more whole on his deathbed than he had been at any other time in his life; and I was more whole as his death approached and as his widow than I had been at any earlier time in my life. In this strange experience of life in death, we were brought close to the mystery which lies at the center of God's redeeming work: that the Lord of the universe has come to us, not in power and in glory, but in weakness and in dust, and has died to give us life. When we see this up close, what is there to say but what Job said: "I had heard of thee by the hearing of the ear, but now my eye sees thee; therefore I despise myself, and repent in dust and ashes" (Job 42:5-6).Margaret Kim Petersonteaches theology at Eastern College in St. Davids, Pennsylvania.
Margaret Kim Peterson wrote an article for Books & Culture last year that discussed the poor theology in recent witchcraft-oriented movies.The full text of Jeremy Taylor's "The Rule and Exercises of Holy Dying" is online, as is John Wesley's sermon, "On Visiting the Sick." An extensive discussion of Basil's "Asceticon" is also online, and the text will soon be posted at the Internet Medieval Sourecebook.Christianity Today has reported on the controversial practice of physician-assisted suicide and how euthanasia proponents often ignore the wishes of the dying. They also look at Christian origins of the hospice industry and how the profit motive may be a threat to quality care. Sister publication Books & Culture has focused on caring for elderly parents while Today's Christian Woman looked at coping with the loss of an elderly parent and spotlighted one woman who is living with breast cancer.An excellent article on how Christians should face death can be found at U.S. Catholic. In 1984, Pope John Paul II issued an apostolic letter on the meaning of human suffering. The United Methodist Church has posted the moving account of how a father lost his young son to AIDS.Rest Ministries is a Christian ministry dedicated to serving people who live with chronic illness or pain.
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